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Isothiazolinone Allergy Epidemic in North America

Dermatitis; ePub 2017 May 1; Zirwas, et al

The epidemic of isothiazolinone sensitivity documented in Europe is now in North America, according to a recent study. During the last decade, the use of methylisothiazolinone (MI) at higher concentrations in both leave-on and rinse-off products has significantly increased. Furthermore, patch testing with only methylchloroisothiazolinone (MCI)/MI 0.01% aqueous (aq) will miss approximately half of isothiazolinone allergy cases, whereas testing with only MI 0.2% aq will miss approximately 10% of isothiazolinone allergy cases. At 13 centers in North America, 4,860 patients were patch tested in a standardized manner with a series of 70 allergens, including MCI/MI 0.01% aq and MI 0.2% aq. Researchers found:

  • 305 patients (6.3%) had a positive reaction to MCI/MI; this is a significant increase from the previous cycle (5.0%, 2011-2012).
  • 521 patients (10.7%) had a positive reaction to MI.
  • These 2 isothiazolinones were among the most common preservative allergens in the 2013 to 2014 cycle; 11.9% of patch-tested individuals were allergic to 1 or both isothiazolinones.
  • Individuals with MCI/MI and MI allergy were significantly more likely to have occupationally related skin disease and hand dermatitis.
Citation:

Zirwas MJ, Hamann D, Warshaw EM, et al. Epidemic of isothiazolinone allergy in North America: Prevalence data from the North American Contact Dermatitis Group, 2013-2014. [Published online ahead of print May 1, 2017]. Dermatitis. doi:10.1097/DER.0000000000000288.

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